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Stillborn baby died due to toxic effects of cocaine, inquest told

Mother was a known drug user who was on a methadone programme for drug addiction

Tue, Jan 16, 2018, 16:06

Louise Roseingrave

Photograph: Cyril Byrne / THE IRISH TIMES

A stillborn baby died due to the toxic effects of cocaine, an inquest has heard.

Baby James was born at the Rotunda Hospital, Dublin, on May 25th, 2016. His mother was a known drug user who was on a methadone programme for heroin addiction.

Paramedics responded to a call for an ambulance shortly before her son was stillborn in hospital, Dublin Coroner’s Court heard.

The woman walked out to the gate of her home to meet the ambulance upon its arrival at 8.33pm, paramedic Stephen O’Neill said.

“She met us at the gate when we pulled up. All her vital signs were normal so we proceeded to hospital,” he said.

Baby James was stillborn at the Rotunda at 9.11pm.

In her autopsy, pathologist Dr Emma Doyle described the baby as normally formed but small for 39 weeks gestation. She noted an acute hypoxic ischemic event that deprived the baby of oxygen and said this may have happened in the days before birth. The cause of death was a brain injury caused by oxygen deprivation to the brain, due to reduced placental blood flow due to the toxic effects of cocaine.

A toxicology report conducted on the baby’s remains found evidence of cocaine, methadone and a variety of benzodiazepines, Dr Doyle told the inquest.

Cocaine alters the placental function by diverting blood flow away from the placenta, the pathologist told the inquest. Dr Doyle said that in her opinion the lack of blood supply to the baby was caused either by a redirection of the blood supply from the placenta to elsewhere in the mother’s body due to the effects of cocaine, or due to the direct effect of cocaine on the foetus. Dr Doyle said there was no range reference for the effects of cocaine on the foetus but said toxicology findings indicated high levels of cocaine had been consumed by the mother.

“There is evidence of levels that can cause death in adults,” Dr Doyle said.

Cocaine alters the placental function by diverting blood flow away from the placenta, the pathologist told the inquest.

“It is my understanding that this was not the first occasion she’d come in [to the hospital] with cocaine in her urine,” Dr Doyle said.

Coroner Dr Myra Cullinane returned a narrative verdict outlining the sequence of events surrounding the baby’s death, including the date and cause of death.

The coroner extended her sympathies to the family, who were not present in court but had been made aware the inquest was taking place.